Inspection on 27/08/06 for Kanner Project (Wixenford)

This inspection was carried out on 27th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kanner Project (Wixenford) 27/11/07

Kanner Project (Wixenford) 16/02/06

Kanner Project (Wixenford) 29/06/05

Kanner Project (Wixenford) 02/11/04

Kanner Project (Wixenford) 29/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Kanner Project (Wixenford) Wixenford House Colesdown Hill Plymouth Devon PL9 8AA Lead Inspector Tina Maddison Unannounced Inspection 27th August 2006 10:00 Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kanner Project (Wixenford) Address Wixenford House Colesdown Hill Plymouth Devon PL9 8AA 01752 895094 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Small House Homes Ltd Vacancy Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: Kanner House is operated by Small House Homes Ltd who own a number of care homes in the Plymouth area. The property is a large detached house that is set in its own grounds near the town of Plymstock. Kanner project is registered to provide care and accommodation to five young people under the category of Learning Disability. Service users may also present behaviours that challenge services. Service users have their own lockable area of the house that includes a bedroom, lounge and bathroom facilities. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 27th August 2006. A pre inspection questionnaire was returned to the Inspector by the Manager prior to the inspection. One relative of a service user, two members of staff, the Manager and Operations Manager were interviewed as part of the inspection. Three survey forms were returned to the Inspector by representatives of the service users, and three staff questionnaires completed by staff were returned. The views of the five service users were not able to be obtained verbally or in writing due to the extent of their learning disabilities. What the service does well: What has improved since the last inspection? Copies of contracts and terms and conditions between the service users and the home are now kept at the home. A plan and timetable of maintenance and refurbishment is now in place. The bedroom window that faced the road has now been fitted with a material that enables the service user to look out but ensures their privacy. The garden is now a pleasant and accessible area for the service users and the construction of an indoor swimming pool is under way. The very worn bed base in the downstairs bedroom has been replaced. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Quality in this outcome area is good because service users have all the information they need to enable them to be sure that their care needs will be met at Kanner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Kanner provides prospective residents with a service users guide. These are produced using symbols that will aid the service users understanding of these documents. There is also a statement of purpose that is available that is also available in a suitable format for people who have a learning disability. Individual contracts are in place but have not all were found to have been signed by the service users or their representatives. Contracts did not contain information regarding rooms to be occupied and details of fees charged. The homes admission procedure remains unchanged, and there have been no new admissions since the previous inspection. The Manager confirmed that prospective service users are able to arrange trial visits and that the Manager would conduct a needs assessment of any prospective service user to ensure that the individuals care needs were able to be met at Kanner. From discussion with the staff, manager and relatives of a service user, and from examination of care plans and daily records, it was evident that service users holistic care needs are currently met at the home. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this area is good because service users are enabled by staff at Kanner House to be as safely independent as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The individual care plans for three service users were examined during the inspection as part of a case tracking process. These detailed documents have been completed using person centred planning processes and cover comprehensively all of the individual service users physical, emotional, health and social care needs and how these will be met the home. The plans described individual restrictions on freedom as all of the service users currently living at Kanner are not able, due to their care needs, to go out of the home alone. These restrictions on freedom have been agreed through a risk assessment process in conjunction with Care Management and representatives of the service user. All of the service users at the home have behaviour that may challenge the service and the individual plans detail how these behaviours are to be managed, and techniques to be used. Consistency of approach is very important as all of the service users have autism. It was evident that the plans are regularly reviewed and updated. Staff confirmed Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 10 that any changes are communicated to them. Individual Plans include short, medium and long term goals. Choices regarding daily living routines are limited as too many choices are difficult for the service users to cope with. The limited choices are offered to some of the service users using symbols and pictures, as their verbal communication is limited. Staff commented that key workers who are familiar with an individual is able to ascertain certain choices by interpreting non verbal behaviours and body language. Service users at the home are not able to manage their money and require assistance for staff. One of the service users who does not have family input has the services of an advocate to assist them to make choices. Service users are encouraged to be as independent as possible, and as part of this process each service user has a detailed risk assessment that covers all activities in the home and outside of the home. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good because personal development is encouraged in all areas of the service users life. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The service users are offered a variety of activities according to their interests and needs. These were evidenced by details in the individual care plans, and by examining each individuals weekly planner that is presented in picture and symbol form to the service users, so that they are able to understand the proposed activities. Three of the service users regularly visit the educational centre that is operated by the company in Plymouth. Here the service users gain skills such as the development of their fine motor skills and work at overcoming demand avoidance. Also on offer are arts and crafts sessions, cooking and sessions aiming to develop the service users social skills. All service users participate in leisure outings to various places of interest around the area. Other leisure activities include visits to the cinema, bowling and visiting the other homes in the group. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 12 Holidays are offered, and this year one service user visited Butlins holiday camp and other service users enjoyed day trips if an overnight stay away from the home would be too stressful for them. Currently under construction at the home is an indoor swimming pool. The home has a large garden, and contained in there is a trampoline and sensory garden. The home also has a well equipped sensory room indoors. The home is situated in an isolated position in the countryside, with no close neighbours, but the service users do visit the nearest town and accompany staff to the supermarket and local shops. Family links are encouraged, and parents are able to visit, and there was documented evidence that service users are assisted to send greetings cards and make telephone calls to family members. Parents who live some distance away are able to stay at accommodation provided by the company. Spiritual needs are respected as documented in individual care plans. Staff were observed knocking on bedroom doors before entering and interacting in a respectful manner with the service users. Rules on smoking, alcohol and drugs are clearly stated in the contract. Menus were examined and evidenced a variety of foods on offer that resulted in the service users enjoying a balanced and healthy diet. A mealtime was observed and it was clear that mealtimes are a pleasant, relaxed and social occasions. Two of the service users preferred to eat alone. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good because service users physical, emotional and healthcare needs are met at Kanner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care plans detailed how the service users preferred to receive personal support. It is very important due to the service users autistic care needs that staff are consistent in their approach, and this is addressed in care plans and at team meetings. Daily living routines are flexible, but structured to some degree to meet the care needs of the individuals in the home. Service users receive additional specialist support and advice as needed from health professionals including speech therapists and the challenging behaviour service. This was evidenced by details in care plans and from speaking with staff, the Manager and a relative of a service user. All service users are registered with a General practitioner and access other healthcare services as required. One service users file that was examined evidenced that specialist healthcare advice and treatment had been obtained for a service user who has colitis, and one service user who has a thyroid condition. Staff training files, and discussion with staff on duty evidenced that staff received accredited training regarding medication. The Manager and the Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 14 Deputy Manager oversee the ordering and monitoring of the medication. Medication records were found to be accurate and up to date. It is a recommendation of this inspection that possible side effects of the medication being taken by the service users are available for staff. Consent to medication that was authorised by relatives if the service user was not able to give this consent was documented. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good because service users and their families can be assured that their concerns will be listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure that is displayed in the home. Survey forms that were returned and discussion with a service users relative evidenced that individuals were aware of how to complain on behalf of their relative should they have a complaint or concern. The relative spoken with believed that when she did have any concerns or issues then they were listened to and the concern acted upon. The Commission for Social Care Inspection has received one complaint in the last twelve months that was not upheld. Staff have undertaken the protection of vulnerable adults training, breakaway training and staff were aware that physical interventions were only used as a last result if distraction techniques failed with an individual and then an intervention was used to prevent injury to themselves, others or to the property. Physical interventions were recorded. Due to the care needs of the service users at Kanner, there has been a high level of interventions recorded. Staff explained that following every intervention they are de-briefed by the Manager and discuss the incident. The home has a policy regarding the handling of service users money. Financial records evidenced that this policy is being followed by staff, and records were found to be correct and up to date. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 Quality in this outcome area is adequate because overall kanner provides a homely and clean environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Kanner House is a large detached property that has been divided so that each service user has their own spacious bedroom, lounge and bathroom and also the use of a communal activities area, dining room and garden. Each area of the house is locked and alarmed in accordance with each service users risk assessment, and this is documented as being agreed with service users families and care managers. A staff intercom is also in place. The home is generally homely and well maintained. One of the service users can not tolerate any pictures or ornaments etc in their bedroom and these would be destroyed due to the destructive behaviours of the service user, so the room appears very bare and functional, and this is agreed by all involved in the service users care. Staff undertake the cleaning of the home as part of their duties. On the day of this unnanounced inspection the home was found to be clean and hygienic. The home has a planned maintenance and renewal programme. A handyman is employed. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 17 Since the last inspection much work has been done in the grounds. The construction of the indoor swimming pool is well underway, and the rest of the grounds have been made into a pleasant area for the service users to use. They have the use of a trampoline, swing and sensory garden. The sensory room is very well equipped and provides a relaxing and therapeutic area for the service users. A discussion during the inspection was held with the manager regarding moving the clinical waste bin away from the front entrance to a more discreet location. The lock on the door leading from the activity room to the garden is broken and consequently is not secure. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35. Quality in this outcome area is adequate because staff at Kanner House are well trained and able to deliver the service users assessed care needs. This judgment has been made using available evidence including a visit to this service. EVIDENCE: Staff confirmed that they have received a job descriptions, and from speaking with staff it was clear that they were aware of their own and others roles and responsibilities. Staff confirmed that training opportunities are good, and a variety of training is offered in such topic areas such as moving and handling, first aid, breakaway training, medication handling and fire prevention. A training plan that is maintained by the Manager was examined The relative of a service user living at the home stated that they were concerned by the high turnover of staff but believed that the home was never short staffed to the detriment of the service users. The Manager confirmed that vacancies had been covered by using staff from the companies other houses and staff offering to undertake overtime. The Manager confirmed that maintaining staffing levels had been a challenge recently but new staff had been recruited recently that would improve the situation. Staffing rotas evidenced that there is nine or ten care staff on duty during the day and at nights there are three night waking staff and two staff who sleep in. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 19 All of the service users currently resident at the home have at least 1:1staffing levels and four of the service users have 2:1 staffing levels during the day. Five staff files were examined and evidenced that the homes recruitment procedure is followed and all files contained all required elements including a CRB check, two references, proof of identity and proof of physical and mental fitness. Minutes of the meetings and from discussion with staff evidenced that staff meetings regularly take place. Supervision takes place on a regular basis and during the inspection supervision notes were available. Staff confirmed that they found supervision helpful and supportive and that it was offered by the manager on a regular basis. Procedures are in place for dealing with physical and verbal aggression towards staff. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this area is adequate because the home would benefit from the registration of the acting Manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting Manager has yet to undertake registration, and as this has now been over six months since the appointment this must be done as a matter of urgency. Ms Slade, the acting manager has completed the Registered Managers Award and holds an NVQ3/4 in care. Records and documents have been reorganised in the home and were easily accessible. Risk assessments covering activities in and out of the home are in place for service users and staff, and all areas of the home have been risk assessed. The accident book evidenced accurate recording of any accidents. Fire prevention logs were up to date and evidenced weekly fire prevention discussions at staff meetings and maintenance of fire prevention equipment. Training in fire prevention is undertaken as part of staff induction procedures. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 21 The home has not yet got automatic water temperature regulators fitted to hot water outlets, but has the water temperature set centrally on the main boiler. Thermostats to be individually fitted have been obtained but are not yet fitted. Radiators are not guarded. Low surface temperature radiators have been ordered but are not yet fitted. Risk assessments could not be found for either the hot water outlets or radiators. Portable electrical appliances had been tested as had electrical and gas systems. The Manager confirmed that a qualified first aider is on duty on each shift. Staff had attended courses on moving and handling as one service user requires regular assistance to move around the home. Insurance cover certificates were displayed in the home. Insurance documents were available for the homes vehicles. There was documented evidence to show that these vehicles are regularly maintained and serviced. A quality assurance and quality monitoring system has yet to be fully developed, although the manager stated that quality is measured by sending out questionnaires to service users relatives, and regular internal audits of the home by the management team. Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 2 3 x 2 x Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 13 The lock on the door between the activity room and the garden must be repaired in order to ensure that the home is secure at all times. The registered person must establish and maintain a system for reviewing and improving the quality of care in the home. This requirement is outstanding from the previous inspection. Radiators must have low surface temperatures, be covered or have a current risk assessment in place. This requirement is outstanding from the previous inspection. Individual temperature control valves must be fitted to individual hot water outlets. This requirement is outstanding from the previous inspection. Requirement Timescale for action 30/09/06 2. YA39 24 31/10/06 3. YA42 13 31/10/06 4. YA42 13 30/10/06 Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA5 Good Practice Recommendations Individual contracts and statements of terms and conditions between the home and the service user should be signed by the service user or their representative. Side effects of medication taken by the service users in the home should be documented and be available for staff. The chemical waste bin should be re-sited away from the front entrance. 2. 3. YA20 YA30 Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kanner Project (Wixenford) DS0000047799.V302571.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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